Möbitz I & II Combined: Arrhythmia Simulator
Report:
Sinus rhythm.
Möbitz 1 [Wenckebach] second degree AV block, with 3:2 and 4:3 periods [top strip].
Möbitz 2 second degree AV block, with 3:2 and 4:3 periods.
Complete RBBB coincident with Möbitz II block.
Complete AV block [bottom strip].
Comment:
The strips were produced by an ECG simulator, programmed to show both types of AV block. Marriott, to whom the strips were sent for an opinion, stated that this has not been seen before in the same strip and expressed relief at the subsequent discovery of their true origin.
I came very close to making a fool of myself. The delight of the âdiscoveryâ was short-lived. It happened when I returned from a conference and was shown the âreally interesting stripsâ the ICU nurses, knowing my interest in ECGs, saved on a patient with known pseudoxanthoma elasticum. They looked very pleased. There is a lesson in this.
Fig 99. 57 year old man with temporary pacemaker in the CCU. The Cardiologist saw the ECG technician taking the trace and told her to turn the pacemaker off, since thereâs no point reporting it. She did, while he walked away.
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